Provider First Line Business Practice Location Address:
1411 UNION BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ALLENTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18109-2423
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
484-695-2886
Provider Business Practice Location Address Fax Number:
610-433-5124
Provider Enumeration Date:
05/25/2007